Brain Cooling as a Potential Treatment for Stroke

Stroke contributes highly to the number of deaths and disability worldwide, current treatments are to treat the source of the clot or to administer treatment for a Hemorrahagic stroke but still the rates of unrecoverable brain damage occurring is high. However new research is being carried out into the effectiveness of Brain cooling as a potential procedure. Will this treatment be worthwhile and more effective than the current treatments?

The Problem

Every year approximately 150,000 people in the UK suffer a Stroke [6]. It is the cause of 53,000 deaths in the UK alone [6] and is one of the leading causes of disability worldwide [1]. A stroke occurs when the flow of blood to the brain is prevented or highly restricted. The most common cause of the stem of blood flow to the brain is blood clots closely followed by aneurysms in the veins. The restriction of blood reduces the amount of oxygen available for the brain cells and the oxygen starved tissue becomes damaged [7]. The diagram to the left shows how a blood clot in a blood vessel can lead to a stroke. It shows how the vessel which is supplying blood to the brain becoming blocked by a blood clot. The arrow in the diagram indicates that the blood is no longer able to travel up the vein and so it forced to stop and be pushed backwards. As the blood is no longer able to pass through the vessel to the brain an area of the brain becomes deprived from oxygen. The diagram shows the area of brain that will be damaged due to this clot by shading a lighter area around where the blocked vessel leads. If the brain is starved from oxygen for up to 60 to 90 seconds then it is prevented from functioning. If this restriction of oxygen continues, after about 10 minutes the damage cannot be reversed [1]. A significant proportion of people’s lives are affected by stoke and a large amount of the health care budget is spent on treating stroke and its aftermath. Current treatments can effectively unblock the clot and restore the oxygen supply to the brain. However they have to be administered within 3 hours of the stroke onset. This creates a problem where sometimes the stroke is not treated fast enough and more damage is caused. For these reasons it is essential that there are advanced treatments that are both effective and efficient to treat stroke and that provide a bit more time in which the doctor can help.

The solution

One potential treatment which researchers are paying special attention to at the moment, is the possibility of using brain cooling (induced hypothermia) as a possible treatment for strokes. This would involve intentionally lowering the temperature of the brain by a couple of degrees bellow normal body temperature to about 33-35ºC, by using ice cold intravenous drips to cool the patients entire body or another technique to put the brain into a state of hibernation. [2] Allowing the brain to survive and to continue functioning with a lower supply of oxygen, reducing the damage that the limited flow of blood is causing. While the brain is in a state of induced hibernation doctors would be given more time to detect and resolve the cause of the blockage or burst of the blood pressure.

The picture to the right from the BBC shows the brains temperature being lowered. You can see the area of brain in which the stoke is occurring which appears as a bright orange area on the scan. It also shows where the brains temperature has been decreased, as it is slightly lighter than the average scan, and is beginning to cool down the damaged area. The cooling of the brain is slowing down the rate of damage. It is claimed by Dr Malcolm Macleod, who is the head of experimental neuroscience at the Centre for Clinical Brain Sciences at the University of Edinburgh, that "Every day 1,000 Europeans die from stroke - that's one every 90 seconds - and about twice that number survive but are disabled.” He claims that the from research he has taken part in, into the potential of brain...

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